Provider Demographics
NPI:1013955962
Name:HALL, AUSTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N GREENSBORO ST
Mailing Address - Street 2:SUITE C-6
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-1833
Mailing Address - Country:US
Mailing Address - Phone:919-962-6919
Mailing Address - Fax:919-445-0414
Practice Address - Street 1:200 N GREENSBORO ST
Practice Address - Street 2:SUITE C-6
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1833
Practice Address - Country:US
Practice Address - Phone:919-962-6919
Practice Address - Fax:919-445-0414
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC2004-006772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC137U5Medicaid
NC137U5Medicaid
NCI25645Medicare UPIN